Lumbar Spine Pain Research Articles

Verification of the Effect of Oral intake of MgS-Containing E-type Chondroitin (GAGs®) in Alleviating Symptoms of Osteoarthritis and Lumbar Spinal Stenosis Pain

Verification of the Effect of Oral intake of MgS-Containing E-type Chondroitin (GAGs®) in Alleviating Symptoms of Osteoarthritis and Lumbar Spinal Stenosis Pain

ASSOCIATION OF RISK FACTORS WITH THE INCIDENCE OF LUMBAR PAIN SYNDROME IN PHYSIOTHERAPISTS AT THE CLINIC FOR PHYSICAL MEDICINE AND REHABILITATION

Introduction: Lumbar pain syndrome encompasses various entities manifested by pain, muscle tension, or discomfort between the lower rib arch and the lower gluteal fold, with or without radiation to the leg.Aim: To examine the association of existing risk factors with the incidence of lumbar pain syndrome in physiotherapists.Subjects and Methods: The research was designed as a cross-sectional study and conducted at the Clinic for Physical Medicine and Rehabilitation, University Clinical Hospital Mostar. The study included physiotherapists of both genders and all age groups who did not have a previous history of spinal disease and had more than one year of work experience. Data were collected through anonymous surveys, and the modified Nordic Questionnaire for musculoskeletal symptom analysis was used as the research instrument. This questionnaire consists of four parts: socio-demographic data, healthcare provision, lower back pain, and job satisfaction.Results: The prevalence of lumbar pain in the last 12 months was around 94.0%. The study involved 56 participants, most of whom were female, with the majority being in the 31-40 age group with higher education. Males were slightly overweight, and the duration of lumbar pain was associated with the gender of the participants.Conclusion: Participants who lifted heavier loads experienced significantly more lumbar spine pain, while the duration of work experience was not significantly associated with the incidence of lumbar pain syndrome. Keywords: lower back pain, risk factors, physical activity, daily life activities, physiotherapists

Efficacy of Laser Therapy in Patient Self-Assessment for Cervical and Lumbar Spine Pain Syndromes – Original Study

Introduction: Laser therapy, or Light Amplification by Stimulated Emission of Radiation (LASER), is a relatively popular method used in rehabilitation for various patient conditions. Purpose: To evaluate the effectiveness of laser therapy in treating pain syndromes of the cervical and lumbar spine. Material: The study included 108 patients, consisting of 72 women (67%) and 36 men (33%) diagnosed with chronic pain syndromes in the cervical and lumbar spine regions. The average patient age was 64.4 years. Method: A proprietary questionnaire survey Results: According to 44.4% of respondents, the effects of laser therapy are moderate, while 28.7% reported significant improvement. The study showed that for 50% of patients, the pain relief was substantial, for 37% it was minimal, and for only 9.3% there was no noticeable improvement. Among the participants, 70.8% of women and 75% of men considered laser therapy to be an effective treatment. Notably, 100 respondents expressed a willingness to undergo laser therapy again in the future. Conclusions: The data indicates that laser therapy is an effective treatment for spinal pain syndromes, often resulting in significant symptom relief. However, the concern is the short duration of pain relief after therapy, with symptoms commonly recurring within a few months to a year. The willingness of 100 respondents to undergo future laser therapy underscores the positive perception of this rehabilitation method among patients.

Acute Severe Inflammatory Lumbar Spinal Pain Induced by Calcium Pyrophosphate Crystals: Computed Tomography Is Everything.

Acute back pain with neurological symptoms is a medical emergency. Here we report a case of severe degenerative spine disease with raised inflammatory markers due to an atypical cause.

Traditional versus dynamic sitting: Lumbar spine kinematics and pain during computer work and activity guided tasks

Dynamic sitting may mitigate low back pain during prolonged seated work. The current study compared pelvis and lumbar spine kinematics, pain, and work productivity, in traditional and dynamic sitting. Sixteen participants completed three 20-min blocks of computer work and activity guided tasks in a traditional office chair or backless and multiaxial rotating seat pan while kinematics were measured from accelerometers on the low back. Pain ratings were recorded on a visual analogue scale every 10 min. Similar pelvis and lumbar kinematics emerged when performing computer work in traditional and dynamic sitting. Pelvis and lumbar sagittal and frontal plane shifts and fidgets were largest for dynamic sitting in the activity guided tasks. Buttocks pain was higher in dynamic sitting, but low back pain and work productivity were unaffected. Dynamic sitting increased spine movement during activity guided tasks, without negatively impacting lumbar kinematics, low back pain, or productivity during seated computer work.

Sacrococcygeal chordoma with spontaneous regression due to a large hemorrhagic component

Chordoma is a malignant bone tumor originating from notochordal remnants, most commonly occurring at the sacrococcygeal junction. We present a case of a 70-year-old male with chronic pain in the lower lumbar spine. MRI performed elsewhere revealed a large tumor that involved S4, S5, and the coccyx with a presacral soft tissue component. The lesion was heterogeneously hyperintense on T2-weighted images with a thick hypointense rim anteriorly. On T1-weighted images, the lesion showed a native hyperintense signal centrally probably due to hemorrhage. Based on this MRI, the diagnosis of chordoma was suggested. A spontaneous marked reduction in size was observed on a 4-week interval MRI performed at our institution before biopsy. Due to spontaneous tumor shrinkage along with peripheral enhancement, a differential diagnosis of infection or bleeding in a retrorectal cyst was proposed. This case teaches us that chordomas may contain a large hemorrhagic component, which is hyperintense on T1-weighted images and shows peripheral rim enhancement. Spontaneous shrinkage of a tumor may occur due to the resolution of a hematoma within weeks. Biopsy is key to obtain the correct diagnosis. Understanding the typical and more rare features of chordomas is key for MSK radiologists as well as pathologists. Chordomas are typically slow-growing tumors, but radiologists should be aware that intratumoral hemorrhage can lead to rapid changes in tumor size, which may be mistaken for either regression or progression of tumor. This case highlights the importance of considering hemorrhagic events within chordomas in the differential diagnosis when observing size fluctuations on imaging.

Long COVID Symptoms vs. Back Pain and Physical Activity among Students in Poland-Cross-Sectional Study.

Back pain (BP) is a common condition that affects people of all ages. Moderate- and vigorous-intensity physical activity (PA) is a key element in maintaining health. The purpose of this research was to determine the level of physical activity and back pain (BP) in students with long COVID symptoms and to determine the relationship between the level of PA and BP in students with and without long COVID. A survey was carried out among 402 students from Poland. The inclusion criteria were as follows: student status, age of over 18 years, history of COVID-19, and consent to participate in the study. The International Physical Activity Questionnaire (IPAQ) was used to determine the level of PA. The Oswestry Disability Index (ODI) and the Neck Disability Index (NDI) were used to assess BP. We found that at least half of the students surveyed did not experience any lumbosacral or cervical spine pain. The authors found no association between the level of PA in women and a history of long COVID symptoms, while there were statistically significant differences in intense PA in men (p = 0.0263), with those who did not report long COVID symptoms being more active. With regard to cervical and lumbar spine pain complaints, in our study, these were statistically significantly stronger in students who were observed to have long COVID symptoms. The difference was not significant only for lumbosacral complaints among men. No strong correlations were found between PA level and the severity of BP. Additional investigation is required to comprehend the complex interaction between long COVID symptoms and levels of PA and BP. Special attention should be paid to the prevention of back pain mainly in the COVID-19 group of students.

Cerebrospinal Fluid Lysophosphatidylcholine Species for Distinguishing Narrowing of the Lumbar Spine

ContextReoperation, sometimes multiple, is common with progressively worse outcomes in patients with degenerative lumbar spine diseases. Lysophosphatidylcholine (LPC), a precursor of lysophosphatidic acid, in the cerebrospinal fluid (CSF) is a possible biomarker for neuropathic pain and discriminating neuropathic pain caused by lumbar spinal canal stenosis (LSCS) from other etiologies. This study aimed to explore this possible use of LPC species in the CSF. DesignUsing liquid chromatography-tandem mass spectrometry, we measured six LPC species, (16:0), (18:0), (18:1), (18:2), (20:4), and (22:6), in the CSF. Setting[Multi-site observational study] ParticipantsPatients with LSCS (n=137) and persistent spinal pain syndrome (PSPS, n=22). InterventionsCSF collection using lumbar puncture. Outcome MeasuresWe compared the LPC values between the groups and determined the cutoff levels that could efficiently discriminate the groups with high accuracy. ResultsThe levels of all measured LPC species were significantly higher in the LSCS group than the PSPS group. Four LPC species demonstrated more than 0.80 area under the curve obtained from the receiver operating characteristic curve analysis. Although the specificity of cutoff levels for the six LPC species was low to moderate, their sensitivity was consistently high. ConclusionThe existing diagnostic protocols combining physical examinations and morphological imaging studies for lumbar spinal pain have limited sensitivity. Measuring LPC species in the CSF is a promising objective laboratory test and could be suitable for detecting the presence of lumbar spinal stenosis and can help indications for surgery.

Hip-spine syndrome: Diagnostic difficulties

Introduction. Hip-spine syndrome (HSS) is a combination of coexisting hip osteoarthritis (OA) and degenerative lumbar spine stenosis (LSS). Main difficulties in treating patients with HSS are in early diagnostics and in choosing right surgery, because mistakes lead to pain maintenance. Existing diagnostic algorithms show right surgery choosing failure in 15–20%. We present results of examination patients with HSS in our survey.The aim – to present clinical and instrumental results of examination of patients with hip-spine syndrome.Materials and methods. We have examined 378 patients with typical pain pattern (buttocks, low back spine, groin and lateral hip) and difficulties in pain source definition. We performed hip X-rays and low back spine MRI.Due to results we divided patients into three groups – patients with HSS (n=100), with hip OA (n=172) and patients with LSS (n=106). We used Harris Hip Score, Oswestry Disability Index and Visual Analogue Score to determine hip and lumbar spine functional status and pain level.Results. Patients with HSS had higher (p<0.05) pain levels (76.5±9.1 mm) than patients with hip (68.3±7.9 mm) or lumbar spine pathology (67.4±7.9 mm). Harris Hip Score in patients wirh HSS (52.7±8.1 points) was same as in patients with hip OA (55.5±9.1 points), Oswestry Disability Index in these patients (44.2±7.6%) was same as in patients with LSS (43.2±7.8%).Conclusion. High pain level and low Harris Hip Score and Oswestry index, along with clinical examination, on first visit can help suspect hip-spine syndrome and recommend both hip and lumbar spine imaging.

The Influence of Age and Work Experience on Lumbar Spine Pain among the Nursing Staff

Introduction. Currently, back pain syndromes are considered to be widely known problems in the medical, but above all, social and economic aspects. The specific nature of the profession performed by nurses puts them among the people most at risk of spine dysfunction.
 Aim. The aim of this study is to assess the occurrence of pain in the lumbar spine pain among nurses working at the Provincial Specialist Hospital in Włocławek.
 Material and Methods. The research was conducted among 120 nurses working in hospital wards of the Provincial Specialist Hospital in Włocławek. The research used an own survey questionnaire and the Revised Oswestry Low Back Pain Disability Scale (ODI) — the Polish version. Consent to conduct the research was obtained from the Management of the Provincial Specialist Hospital in Włocławek and the Bioethics Committee of the State Academy of Applied Sciences in Włocławek.
 Results. The majority of respondents indicated that they connect back pain with work — 104 people (86.7%) and received the results of slight limitations — 60 people (50.0%). Most respondents indicated that they had experienced pain for 1–5 years — 42 people (35.0%). Respondents aged up to 45 years indicated that they had been experiencing pain for 1–5 years — 15 people (48.4%). In the group with 30–40 years of experience, the most respondents indicated that they had more than 10 years of experience — 19 people (34.5%). In the group with 30–40 years of experience, the majority indicated that often several times a month — 21 people (38.2%). The highest degree of disability was recorded at the age of 56–62, serious disruptions — 8 people (33.3%), and at the age of 51–55, serious disruptions — 6 people (14.03%).
 Conclusions. The work performed affects the occurrence of pain in the lumbar spine. Age groups up to 45 years and 46–50 years have been experiencing pain for 5–10 years. Pain is most often experienced by respondents with 30–40 years of work experience. The vast majority of respondents experience slight limitations. The highest rate of disability is experienced by nurses aged 51–55. (JNNN 2023;12(4):164–169)

The Effectiveness of Osteopathic Treatment in Bowel Constipation Patients: A Clinical Perspective

Introduction: Functional chronic bowel constipation is a motility disorder of great relevance and prevalence worldwide. Objective: Analyze the efficiency of visceral manipulation technique in individuals with bowel constipation diagnose according to Roma III criteria. Methods: This is a crossover clinical study that included individuals of both genders aged between 20 and 40 years who had had bowel constipation symptoms for over one year. Individuals were randomized into two groups: the intervention (IG) and control (CG) groups. A four weeks washout period was given. Each volunteer underwent 24 individual osteopathic sessions, twice a week that lasted up to 30 minutes. Three intervention techniques were performed: two for the large intestine and one for the small intestine. Results: Thirty four patients were recruited but nine were excluded. Our sample consisted in 25 participants, 13 were allocated in the IG and 12 in the CG. No significant difference was found between groups for anthropometric, educational, marital status, proportion of smokers and alcoholics, and VAS for lumbar spine pain measures. Lumbar spine flexibility, was significant increased for the IG (p<0.0001). A higher proportion of patients in the IG presented reduced hard stools, effort to evacuate, incomplete evacuation feeling, anorectal obstruction sensation and manual maneuvers to facilitate evacuation after treatment (p<0.0001). A significant correlation was found between pain (VAS) and the Schober test (r=-0.41). Conclusion: This study was successful in showing that there seems to be a positive effect of the osteopathic treatment for chronic bowel constipation at short and long terms.

Low back pain occurrences and gynecological disorders in female equestrians and strengthening of core stability muscles lumbar spine

Introduction. Women involved in amateur equestrian activities may encounter spine pain and discomfort in the lower pelvic region. Aim of the Study. A research hypothesis was established, suggesting that training the muscles responsible for stabilising the lumbar spine may have a positive impact on reducing both lumbar spine pain sensations and gynaecological disorders among female horse riders. The study aimed to validate the hypothesis and compare the Revised Oswestry Low Back Pain Disability Scale Questionnaire in the Polish version and the author’s questionnaire on gynaecological complaints between the study and the control group. Material and methodology. The study involved women (n = 23) engaged in equestrian activities with an age range of 22.23 ± 2.78 years, research group n = 11 and n = 12 control group. Questionnaires used: Revised Oswestry Low Back Pain Disability Scale and the author’s on gynaecological ailments. Questionnaires were completed before and after a training session focused on exercising the stabilising muscles. Daily exercise training was conducted in the afternoon for six weeks (30 repetitions for each exercise). Results. The results were presented in the form of graphs. Conclusions. The six-week training of the stabilising muscles has a positive impact on reducing lumbar back pain and a slight effect on gynaecological complaints.

Lower back pain caused by radiculopathy induced by lumbar stenosis - literature review

Introduction: Lumbar spine pain is a common clinical problem. Due to the multitude of causes of pain, it is important to know the most common ones in order to choose an effective method of treatment. The aim of this study: Summary of current knowledge regarding back pain caused by radiculopathy associated with lumbar stenosis. Material and method: The review includes publications published in 1995-2020. The search of the publications in the Pubmed database was carried out using the following keywords: back pain, radiculopathy, lumbar stenosis. Description of the stage of the knowledge: Lumbar radiculopathy caused by lumbar stenosis is a common clinical problem, especially in older age groups. In diagnostics, an interview with the patient, physical examination and imaging tests - especially CT and MRI - are important. In most patients, conservative treatment is sufficient - the use of analgesics and anti-inflammatory drugs and physiotherapy. In justified cases, surgical treatment should be considered as the most effective causative treatment of the disease. In the last 20 years, the availability of both diagnostic methods has increased and new surgical techniques have appeared, aiming at minimally invasive treatment. Summary: Radiculopathy caused by lumbar stenosis is a contributing factor to the occurrence of pain, which can hinder the normal functioning of the patient.Proper diagnosis, identification of the impact and methods of treatment, both conservative and surgical, can help the patient and affect his quality of life. Early diagnosis and treatment are crucial for the effective treatment of pain associated with radiculopathy caused by lumbar stenosis.

Evaluation of therapeutic management in women with lumbar spine pain complaints

Aim of the study: To evaluate the effects of two different modes of improvement on the level of perceived pain, spinal mobility, lumbar spinal motion control and limitations in activities of daily living in women aged 51–62 with lumbar spine pain. Material and methods: The study included a group of 31 women between the ages of 51 and 62. The subjects were divided into 2 groups. Group I (FK) received physical therapy treatments and general gymnastics, while group II (FS) received physical therapy treatments and exercises using a PBU stabilizer. The project covered a period of 10 treatment days excluding Saturdays and Sundays. Before and immediately after the rehabilitation, tests of flexion and extension control in the L-spine, active knee joint flexion test, Schober test were performed, and the NRS scale was used scale and QBPDS scale. Results: After the applied rehabilitation, a significant reduction in the level of perceived pain and improvement in spinal mobility in the direction of flexion were observed in both groups. In the FS group, there was also a significant improvement in lumbar flexion control and better lumbar spine control during the active knee flexion test. In addition, a reduction in disability as measured by the QBPDS scale was noted. Conclusions: The use of comprehensive rehabilitation brings significant improvements in terms of pain reduction and improvement in lumbar spine mobility in the flexion direction. A two-week exercise program using a stabilizer appears to yield significantly better results in terms of lumbar flexion control as well as better lumbar control during the active flexion test of both knee joints. And this, in turn, may affect the results obtained using the QBPDS scale among FS subjects.

Effect of Lumbar Spine Mobility and Postural Alignment on Menstrual Pain in Young Women.

(1) Background: Studies indicate that 45 to 95% of women suffer from painful periods. Despite frequent incidence, the problem is still underestimated. Menstruation-related ailments often correlate with high absenteeism at school and work, as well as limitation of social and scientific activity. The aim of this study was to assess the relationship between the size of the curvature, the mobility of the spine in the sagittal plane, and menstrual pain in young women. (2) Methods: The analysis included 224 women aged 18-26, mean of 21.56 ± 1.95, studying at the College of Medical Sciences of the University of Rzeszów. For this purpose, the measurement of the anterior-posterior curvature of the spine with a gravitational inclinometer, the Schober test and the authors' questionnaire related to menstruation were used. (3) Results: The data analysis demonstrated a significant difference between the group with menstrual pain (MP) and the control group without pain (CG), where the angle of the lumbar sacral transition (p = 0.034), thoracolumbar transition (p = 0.044) and lumbar lordosis (p = 0.006) were statistically significantly lower in MP compared to CG. There were no significant differences in the measurement of the so-called smartphone hump and between the mobility of the lumbar spine and menstrual pain in any of the groups. (4) Conclusions: Women with menstrual pain are characterized by reduced lumbar lordosis and thoracic kyphosis, while sagittal mobility of the spine does not affect pain.

Investigation of the relationship between lumbar spine MRI findings and pain in patients who received and did not receive Parkinson's treatment

Objectives: Parkinson's disease is a chronic, progressive neurodegenerative disorder. Pain is a common symptom in Parkinson's disease, but the prevalence, characteristics, and documentation of its relationship with Parkinson's disease are insufficient. In this study, it was aimed to evaluate the relationship between lumbar spine magnetic resonance imaging (MRI) findings in patients who received and did not receive Parkinson's treatment. Methods: The demographic characteristics of patients with diagnosed Parkinson's disease were retrospectively obtained from the records. Their pain was grouped and the Hoehn Yahr stage at the first examination, and the interventional treatments performed were recorded. MRI measurements were made in the axial plane and sagittal plane of the spinal canal, whereas Ligamentum flavum measurements were made on both the right and left sides. Results: Twenty-six patients were included in the study. The average age was 73.5. Notably, 57.7% of patients were not diagnosed with Parkinson's disease prior to admission, while the Hoehn Yahr stage mostly comprised Stage 2 with 53.8%. Additionally, low back, waist, and hip pain was observed in 84.6% (n = 22), whereas 61.5% (n = 16) of patients experienced radicular pain. Epidural injections accounted for 33.2%. On lumbar MRI, the most narrow spinal segment on axial measurement was shown to be L4-L5. The axial spinal canal measurement of the Hoehn Yahr 1 group was observed to be significantly lower than the Hoehn Yahr 2 group. Conclusions: Optimal management for lumbar pain that increases with age is currently inadequate. There is a need to conduct larger studies on pain complaints, which is one of the frequently experienced non-motor symptoms in Parkinson's disease, as well as the interventional methods applied.

Spinal epidural empyema in a colobus monkey

AbstractA 10‐year‐old, male colobus monkey presented with a kyphotic appearance. Lumbar spinal pain was suspected, and the colobus was started on a course of meloxicam. With no improvement noted, it was sedated for examination. Haematology revealed a neutrophilia. An empirical course of clavulanate potentiated amoxicillin was started. With no improvements seen after a 10‐day course, clinical examination was repeated. Abdominal ultrasound and abdominal radiographs revealed an abdominal effusion near the lumbar vertebrae, and haematology revealed a neutrophilia with toxic neutrophils. An enrofloxacin course was started. Three days later, the colobus presented with acute paraplegia with neurolocalisation to the T3–L3 spinal cord segments. A magnetic resonance imaging of the vertebral column was performed. Magnetic resonance imaging revealed multifocal osteolytic vertebral body lesions, compression fractures of multiple vertebral bodies and ventral spinal cord compression. Differential diagnosis included infectious osteomyelitis with spinal epidural empyema or less likely, neoplasia. Due to the poor prognosis, euthanasia was elected.

Study of the Effect of Zhuang Medicine Aponeurotic System Triple Therapy on Lumbar Disc Herniation and Alpha-1 Acid Glycoprotein Level

Objective: To analyze the application effect of Zhuang medicine aponeurotic system triple therapy in the treatment of lumbar disc herniation and its effect on the level of alpha-1 acid glycoprotein (alpha-1 AGP). Methods: 200 patients with lumbar disc herniation were selected and randomly divided into a treatment group and a control group, 100 cases in each group. The control group was given conventional acupuncture, and the treatment group was treated with manipulation + fire needling + cupping. The alpha-1-AGP levels before and after treatment, as well as the lumbar spine function and pain scores before and after treatment, and the adverse reactions occurred during treatment between the two groups were compared. Results: Before treatment, there was no significant difference in alpha-1 AGP levels, lumbar function, and pain scores between the two groups (P > 0.05). After treatment, the lumbar function scores of the two groups were significantly increased, with the treatment group having higher scores than the control group (P < 0.05); the incidence of adverse reactions in the treatment group was 2.00%, which was much lower than the control group (P > 0.05). Conclusion: Appropriate application of Zhuang medicine aponeurotic system triple therapy in the clinical treatment of lumbar disc herniation can promote the improvement of alpha-1 AGP index level, reduce the pain degree of patients, and improve their lumbar spine function. At the same time, Zhuang medicine also has significant advantages in terms of safety, while ensuring the efficacy and safety of the treatment.

Does osteoporosis cause pain even without a fracture? An observational study

Introduction/background Osteoporotic fractures are usually painful. However, data on whether osteoporosis without fracture causes pain are insufficient. This study aims to determine whether osteoporosis without fracture is the cause of pain. Methodology Patients aged over 18 years who visited the Physical Medicine and Rehabilitation outpatient clinic of a tertiary university hospital for dual-energy X-ray absorptiometry scan and were suitable for dual-energy X-ray absorptiometry scan without a history of fracture were included in the study. Patients with a history of fractures or those with fracture/fracture sequelae on X-rays were excluded. The cervical, lumbar, and thoracic spine and general body pains of the patients were questioned and dual-energy X-ray absorptiometry results were recorded. Results The study was conducted with 139 patients. Lumbar bone mineral density and T score values of the patients were found to be negatively correlated with the numerical rating scale levels of the cervical, thoracic, lumbar spine, and general body pain. Hip total bone mineral density and T score values were also negatively correlated with numerical rating scale scores of the lumbar and thoracic spine and general body pain. When the patients were divided into two groups as those with and without osteoporosis, it was found that the cervical, lumbar, thoracic spine, and general body pain numerical rating scale levels of the patients with osteoporosis were significantly higher than the group without osteoporosis. Conclusion The results of this study showed that osteoporosis might be associated with pain even though there is no fracture.

Symptom-imaging correlation in lumbar spine pain.

Lumbar spine MRI is associated with a high prevalence of morphological abnormalities in both symptomatic and asymptomatic individuals. A difficult challenge, therefore, is distinguishing the relevant findings causing symptoms from incidental findings. The accurate diagnosis of pain generator is important because misdiagnosis can negatively impact patient management and outcome. Spine physicians use clinical symptoms and signs to interpret lumbar spine MRI and make treatment decisions. Symptom-MRI correlation enables the targeted inspection of images for pain generator. Radiologists can also use clinical information to improve diagnostic confidence and the value of dictated reports. Because high-quality clinical information may be difficult to obtain, radiologists often generate lists of lumbar spine abnormalities that are otherwise difficult to rank as pain generators. Based on the literature review, this article attempts to distinguish the MRI abnormalities that may represent incidental findings from the abnormalities that are more commonly associated with lumbar spine-related symptoms.